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Healy, K. (2002). Confidentiality and Mental Health edited by Christopher Cordess (Jessica Kingsley, London, 2001) 207 pp. £15.95.. Psychoanal. Psychother., 16(3):275-277.

(2002). Psychoanalytic Psychotherapy, 16(3):275-277

Confidentiality and Mental Health edited by Christopher Cordess (Jessica Kingsley, London, 2001) 207 pp. £15.95.

Kevin Healy

Why all the current fuss about confidentiality and mental health? Confidentiality is a burning issue on the Council of the Association of Psychoanalytic Psychotherapy. Council members are bothered by the implications of the Data Protection Act, which makes therapists’ process notes of sessions part of the official medical notes. They are further bothered by impending legislative changes, broader issues concerning confidentiality of clinical notes, and confidentiality concerning the publication of patient material in the APP Journal and elsewhere. By the time you read this review, there will have been a lecture, a response and a debate at the APP Annual General Meeting concerning confidentiality. While it certainly is a burning issue, is it also a hot potato? Hot potatoes need to cool before they can be eaten as a source of energy and nourishment.

Feelings become inflamed around the issue of confidentiality. Ruth Wyner, who reviewed this book for Therapeutic Communities, was imprisoned for keeping to her understanding of confidentiality. (Details of the history of this case and some of the disturbing issues it raised are available on the ‘Cambridge Two’ website, http://www.cambridgetwo.com). Christopher Cordess, who delivered the APP annual lecture on confidentiality, is also editor of this stimulating book, Confidentiality and Mental Health. It struck me on reading his contribution that he is clearly bothered, concerned and worried about the issue of confidentiality. Some chapter authors highlight more the confusion and angst around the issue, while others present clear pragmatic guidance on possible ways forward. Those who work currently in multidisciplinary teams seemed less worried about theoretical and philosophical issues surrounding confidentiality. Other authors were clearly less confident about the merits of multi-agency working. This was reflected in their views on confidentiality. Social workers are more adept at multi-agency working, at not acting in isolation, and perhaps in recognizing that the law rarely provides direct answers. Those working in the legal field contributed clearly thought-out and clearly written chapters that seemed less fuelled by emotional issues.

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